Provider Demographics
NPI:1164462495
Name:EVRARD, MONICA LYNN (MSPT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNN
Last Name:EVRARD
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3340
Mailing Address - Street 2:NEW VALLEY REHAB
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18043-3340
Mailing Address - Country:US
Mailing Address - Phone:484-851-3386
Mailing Address - Fax:484-851-3469
Practice Address - Street 1:4136 W TILGHMAN ST
Practice Address - Street 2:SUITE 5 ST LUKES PHYSICAL THERAPY
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4428
Practice Address - Country:US
Practice Address - Phone:610-530-2363
Practice Address - Fax:610-530-2364
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
50047799OtherCAPITAL ADVANTAGE BLUE CR
PA50047799OtherCAPITAL
PT017320OtherUS DEPT OF LABOR
2360169000OtherHMO KEYSTONE EAST
7911762OtherPPO
PAEV1687380OtherHIGHMARK
EV1687380OtherBLUE SHIELD PA HIGHMARK
105960BOtherHMO
1687380OtherPPO PERSONAL CHOICE